In this account of vaccination's miraculous, inflammatory past and its uncertain future, journalist Arthur Allen reveals a history both illuminated with hope and shrouded by controversy--from Edward Jenner's discovery of smallpox vaccine in 1796 to Pasteur's vaccines for rabies and cholera, to those that safeguarded the children of the twentieth century, and finally to the tumult currently surrounding vaccination. Faced with threats from anthrax to AIDS, we are a vulnerable population and can no longer depend on vaccines; numerous studies have linked childhood vaccination with various neurological disorders, and our pharmaceutical companies are more attracted to the profits of treatment than to the prevention of disease.--From publisher description.

More than 76 million Americans have hypertension, or high blood pressure, which can shorten life by 10 15 years if left untreated. Hypertension increases the risk of developing cardiovascular diseases (CVD) such as stroke, heart attack, congestive heart failure, or kidney failure that are often debilitating and impact quality of life. Prevention is the key to minimize CVD risk and increase longevity, but accurate prognosis of a future disease is difficult. Elevated blood pressure (BP) is generally the first sign of risk, but measuring pressure alone does not provide insight to where in the body problems may exist. Therefore, other screening tests are needed to more specifically isolate the underlying cause, which would improve the selection process of prescribing medications, or diet and exercise changes. And similar to BP measurements, such hypertensive screening tests may need to be performed at home to improve accuracy, since doctor's visits often trigger physiological responses that falsely elevate and lower BP. To address these concerns this work describes the design and validation of a home based noninvasive system (a bathroom scale) to measure aortic pulse wave velocity (PWV), to assess arterial stiffness, which is a clinical risk factor for certain CV diseases. The purpose of this work was four-fold: to develop a home monitoring device with simple user operation; to develop biomechanical theories as to why forces in the aortic arch can be sensed synchronously at the feet; clinically validate the biomechanical theory; and to demonstrate potential clinical utility of standing PWV measurements for trending and prognosis. The PWV scale is comprised of two different sensing technologies, ballistocardiography and photoplethysmography, which are embedded in the scale to measure pulse arrival times in the aortic arch and the foot--simply by standing on the scale. Using this system, PWV can be routinely determined in less than 30-seconds--significantly faster than commercial systems using trained operators. To validate this PWV system, a novel biomechanical theory was developed called Central Aortic Forces (CAF) to explain how the cardiovascular forces inside the body can be synchronously sensed outside the body. The computational models accurately predicted the amplitude of forces in the aortic arch (2-3 Newtons at rest), which were empirically confirmed in a clinical study; the empirical results agreed within 10% of the theory. To demonstrate trending abilities, a longitudinal PWV study was also performed over a four month duration, with results highly correlated to the applanation methods. Finally, an age study was conducted to characterize arterial aging, which matched well (p< 0.01) in slope and intercept major clinical trials published in the literature using applanation PWV (clinical gold standard). Examples are given on how such a system may improve prognosis to detect early vascular aging in young adults, otherwise masked in standard blood pressure measurements.

Values-based practice in health care : setting the scene -- Teamwork and collaborative practice in modern health care -- Communication within teams and between professionals -- A patient complaint : team meetings, policy, and practice values : raising awareness in the team -- A well person health check, health promotion, and disease prevention : different lifestyles, different values -- A patient with medically unexplained symptoms : applying evidence and values -- A request for strong analgesia : honesty and truth -- Asylum seekers and refugees : working across cultures -- A request for a home birth and other pregnancy related consultations -- Community based care and the wider health care team / Dawn Forman -- Ageing and end of life decisions -- Referrals and the interface between primary and secondary care: looking after "our" patients -- Living with visible difference and valuing appearance -- Collaboration with other professionals : in and outside health care -- Learning in and about teams.

"Variation in Health Care Spending investigates geographic variation in health care spending and quality for Medicare beneficiaries as well as other populations, and analyzes Medicare payment policies that could encourage high-value care. This report concludes that regional differences in Medicare and commercial health care spending and use are real and persist over time. Furthermore, there is much variation within geographic areas, no matter how broadly or narrowly these areas are defined. The report recommends against adoption of a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units. Rather, to promote high value services from all providers, Medicare and Medicaid Services should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients."--Publisher's description.

Herpes zoster ophthalmicus (HZO) is a common disease in the elderly and the immunosuppressed, with potentially devastating sequelae. Diagnosis of HZO is clinical but almost all its manifestations are non-specific and often indistinguishable from those due to other causes in general and herpes simplex virus in particular. The exception is varicella-zoster virus epithelial keratitis, which is frequently the only indicator of the true nature of the disease. This book is unique in presenting high-magnification images, obtained by non-contact in vivo photomicrography, that capture the distinctive features of varicella-zoster virus epithelial keratitis in HZO. Both the morphology and the dynamics of the corneal epithelial lesions are splendidly documented, including in patients with HZO sine herpete and recurrent disease. Three rare cases of ocular surface involvement in acute HZO are included, and the final chapter offers an illuminating comparison of varicella-zoster virus epithelial keratitis in HZO and the lesions of herpes simplex virus. This book will serve as an indispensable aid in the prompt diagnosis of HZO.

IL-6 is a pleiotropic cytokine with roles in many areas of biology; it is also implicated in diseases associated with inflammation. To understand how a molecule is capable of diverse effects, one must understand how cells respond to it. In most published studies, the mechanism of IL-6 signaling has been evaluated in cell lines with limited biological relevance. In this study, phospho-specific flow cytometry and other techniques were used to look closely at IL-6 signaling in primary murine lymphocytes. Splenic T cells, but not B cells, exhibited a strong phospho-STAT1 response to IL-6 in addition to the universally observed STAT3 activation. Interestingly, when IL-6 dose was reduced, T cells exhibited a B cell-like signaling phenotype; they had no phospho-STAT1 response to IL-6. STAT3 had a greater affinity than STAT1 for gp130, the IL-6 signal transducer, which allows STAT3 to become activated when IL-6 is scarce. In our system, STAT1 played a dual role in gene transcription downstream of IL-6. In contrast with previous reports, phospho-STAT1 was required for expression of a subset of genes, which indicates that nature has the ability to create a STAT1 knockout-like condition by stimulating cells with a low level of IL-6. A novel inhibitory function of STAT1, which indicates a modality used to influence TH biasing capability of IL-6, was also discovered. This work gives insight as to how a single molecule, IL-6, affects the immune system, the central nervous system, and metabolism in such complex ways.

The placenta is an organ that connects the developing fetus to the uterine wall, thereby allowing nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. Proper vascular development in the placenta is fundamental to ensuring a healthy fetus and successful pregnancy. This book provides an up-to-date summary and synthesis of knowledge regarding placental vascular biology and discusses the relevance of this vascular bed to the functions of the human placenta.

Vascular Mechanisms in CNS Trauma focuses on the vascular aspects of brain and spinal cord trauma.Twenty nine chapters are arranged in three sections:Molecular Mechanisms; Experimental Models and Methods; and Clinical Challenges and Opportunities. The first section addresses topics in the basic biology of brain and spinal cord trauma, ranging from the pathophysiology of cerebral endothelial cells and gliovascular interactions to the role of stem cells in neurovascular repair. The second section covers experimental methods in rodent and in large animal models of CNS injury, as well as the use of biomaterials and biomarkers in studying the mechanisms of tissue response. The third section deals with clinical issues in the monitoring and treatment of the patient with traumatic injury of the brain and spinal cord. Contributors to the book include an integrated mix of basic scientists and clinicians from diverse institutions. By presenting salient issues in CNS trauma from a vascular perspective, this book should make a unique contribution to the understanding of traumatic brain and spinal cord injury.

Make the most of today's innovative medical therapies, advances in vascular imaging, and new drugs to improve your patients' cardiovascular health with Vascular Medicine, 2nd Edition. This comprehensive, clinically focused volume in the Braunwald's Heart Disease family provides an in-depth, state-of-the-art review of all vascular diseases, with an emphasis on pathophysiology, diagnosis, and management - giving you the evidence-based guidance you need to make appropriate therapeutic decisions on behalf of your patients. Gain a state-of-the-art understanding of the pathophysiology, diagnosis, and management of arterial disease, venous disease, lymph dysfunction, connective tissue disease, vascular disease, and vascular manifestations of systemic disease. Benefit from the knowledge and experience of Dr. Mark A. Creager (editor of the Vascular Medicine society journal), Dr. Joshua A. Beckman, and Dr. Joseph Loscalzo, and benefit from their practice rationales for all of today's clinical therapies. Easily reference Braunwald's Heart Disease, 9th Edition for further information on topics of interest.

Proteomics is a rapidly expanding investigation platform in cardiovascular medicine. Driven by major improvements in mass spectrometry (MS) instrumentation and data analysis, the proteomics field has flourished in recent years particularly in the study of complex diseases. These recent advances are characterized by the development of quantitative MS-based methods that promoted the field from primarily identifying proteins to also providing measurements of relative changes in protein levels between different cell states. This progress is reflected in the application of proteomic techniques to vascular pathology. Vascular Proteomics: Methods and Protocols provides up-to-date methods and protocols for the analysis of arteries, cells, lipoproteins, body fluids, and metabolites, with a particular focus on MS-based methods of protein and peptide quantification. Written in the successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible protocols, and notes on troubleshooting and avoiding known pitfalls. Authoritative and easily accessible, Vascular Proteomics: Methods and Protocols is a representative selection of methods that can be a useful resource for experienced proteomics practitioners as well as newcomers interested in becoming acquainted with the practice of proteomic techniques for cardiovascular research.

"The first federally-funded meeting on tissue engineering was in 1988. In this and subsequent meetings, the fields of tissue engineering and regenerative medicine (TERM) have been described as having the potential to revolutionize clinical approaches to the replacement, reconstruction or regeneration of organs and tissues. While TERM research has resulted in new patient treatments, the broad impact on clinical practice envisioned has not been achieved. The development of new TERM therapies that have significant clinical impact requires the ability to control vascularization, the process of new vessel assembly. The circulatory system plays a number of vital roles in regenerating and functioning tissues. It supplies oxygen and nutrients, removes wastes and is a source of multiple cell types required to respond to changing physiological conditions. For nearly every TERM application, the ability to enhance, regenerate or engineer new tissues requires spatial and temporal control over the process of vascularization. While vascularization is being studied in a number of physiologic and pathologic processes, TERM applications present distinct challenges. For example, unique microenvironmental conditions result from biomaterial and cell combinations used in TERM applications that are not encountered in any other system. In addition, clinical applications require vascularization of large tissue volumes within time frames that are much lower than those found during vascularization in development and typical physiologic processes. These requirements place significant constraints on the design of TERM therapies"--Provided by publisher.

In this second edition, the authors discuss the newly discovered entity of IgG4 related diseases, look in greater detail at the role of biologic treatment in ANCA associated vasculitis, and have revised the nomenclature in each chapter to reflect international consensus. The addition of illustrations as well as online video content helps the reader manage patients with these potentially devastating conditions. Vasculitis in Clinical Practice, Second Edition, is a useful and concise volume that will help physicians in training, primary care physicians and nurse practitioners in quickly and easily recognizing the key and salient points of each condition.

This book is exceptional in being devoted solely to vasovagal syncope (VVS), the most frequent cause of transient loss of consciousness in the general population. All aspects of VVS are covered, including epidemiology, pathophysiology, diagnosis and differential diagnosis, prognosis, therapy and implications for particular activities such as work, driving and physical activity. The context for the book is that about half of the population suffer from this type of loss of consciousness during their lifetime and then often call for general practitioner and/or emergency room assistance. While many pathophysiological aspects of VVS have been clarified, others remain elusive. The diagnosis of VVS may be easy, but it is sometimes challenging. From the therapeutic standpoint, few evidence-based therapies have been established and the large majority of treatments remain unsatisfactory. Vasovagal Syncope presents the latest evidence on all these issues and will be of value for internists, cardiologists, neurologists, emergency physicians and general practitioners.

Cruciferous vegetables and biological activity of isothiocyanates and indoles -- Green leafy vegetables in cancer prevention -- The role of tomato lycopene in cancer prevention -- [Beta]-carotene and other carotenoids in cancer prevention -- The role of alliums and their sulfur and selenium constituents in cancer prevention -- Molecular mechanisms of chemoprevention with capsaicinoids for chili peppers -- Influence of dietary soy isoflavones genistein and daidzein on genotoxicity and mammary carcinogenicity in rats exposed to the model carcinogen 7, 12-dimethylbenz[a]anthracene (DMBA) -- The potential roles of seeds and seed bioactives on the prevention and treatment of breast and prostate cancer -- Nuts as part of a whole diet approach to cancer prevention -- Whole grains and their constituents in the prevention of colon cancer.

This book is the first significant contribution to thoroughly examine the potential hazards associated with snakes of the former family, Colubridae. This family contained >65% of living snake species (approximately 3,000 taxa) and has recently been split into multiple families. Many of these snakes produce oral secretions that contain toxins and other biologically-active substances. A large variety of these snakes figure in the pet industry, yet little documented information or formal study of their potential medical importance has been published. Therefore, although the possible medical importance of many of these species has been subjected to speculation since the mid-nineteenth century, there is a limited amount of useful descriptive information regarding the real hazard (or lack thereof) of snakes belonging to this diverse, artificial family. There is a need for "one-stop shopping" offering information regarding their possible toxicity and clinical relevance as well as recommendations for medical management of their bites. This book is the first synthesis of this information and includes evidence-based risk assessment, hazard rankings and specific recommendations regarding important species, many common in captivity. Fills a gap in the toxinological, medical and herpetological literature by providing a comprehensive review of this entire assemblage of snakes, with particular attention given to their capacity, real or rumored, to cause harm to humans A patient-centered, evidence-based approach is applied to analyzing documented case reports of bites inflicted by approximately 100 species. Clinical management of medically significant bites from non-front-fanged colubroids is methodically reviewed, and specific recommendations are provided.

Gastroesophageal Reflux Disease in Children with Cystic Fibrosis -- Sleep-Related Breathing Disorders and Bruxism -- Absence of Typical Symptoms and Comorbidities in Patients with Central Sleep Apnea -- Causes of Chronic Cough in Non-Smoking Patients -- Diseases of the Upper Respiratory Tract in Preschool and School Age Children in Ambulatory Ear Nose Throat Practice -- Assessment of Air Pollution Effects on the Respiratory System Based on Pulmonary Function Tests Performed during Spirometry Days -- Development and Evaluation of Predictive Models in Tuberculous Pleuritis -- The Influence of Asthma Exacerbations on Health-Related Quality of Life -- Increased Serum IgA in Children with IgA Nephropathy, Severity of Kidney Biopsy Findings and Long-Term Outcomes -- Product Failures in Respirators and Consumables: Analysis of Field Safety Notices of 2005-2013 publicized by the Federal Institute for Drugs and Medical Devices in Germany.

This book focuses on how ventricular assist devices (VADs) can help provide destination therapy for patients with terminal heart failure, one of the most serious diseases in the world today because of the tremendous number of patients, the high mortality rate, and the cost of care. One means of providing cardiological support for patients suffering from heart failure is with VADs, and more than 10,000 patients worldwide have now been implanted with these devices. Half of them already have lived more than one year, and 2,000 patients more than two years, after surgery. This improved survival means that we have reached a point where VADs can be used for destination therapy, not just for bridge-to-recovery or bridge-to-transplant. In view of the increasing number of patients with advanced-stage heart failure and the availability and longevity of transplanted hearts, VADs can solve many problems. In addition to providing information about the devices themselves, this book includes vital guidelines on long-term management and support of VAD-implanted patients' everyday lives.

"This book provides a comprehensive overview of topics describing the earliest steps of fertilization, from egg activation and fertilization to the activation of the zygotic genome, in various studied vertebrate model systems. The contribution of maternal and paternal factors and their role in the early embryo as parental DNA becomes modified and embryonic genes become activated is fundamental to the initiation of embryogenesis in all animal systems. It can be argued that this is a unique developmental period, when information from the parents is compressed to direct the development of the body plan of the entire organism, a process of astounding simplicity, elegance and beauty. In addition to their fundamental scientific interest, many frontiers of biomedicine, such as reproductive biology, stem cells and reprogramming, and the understanding of intergenerational diseases, depend on advances in our knowledge of these early processes. Vertebrate Development: Maternal to Zygotic Control brings together chapters from experts in various disciplines describing the latest advances related to this important developmental transition. Each chapter is a synthesis of knowledge relevant to all vertebrates, with details on specific systems as well as comparisons between the various studied vertebrate models. The editorial expertise encompasses the fields of major vertebrate model systems (mammalian, amphibian and teleost) ensuring a balanced approach to various topics. This unique book&with its combination of in-depth and up-to-date basic research, inter-species comprehensiveness and emphasis on the very early stages of animal development&is essential for research scientists studying vertebrate development, as well as being a valuable resource for college educators teaching advanced courses in developmental biology"--Publisher's description.

This book addresses the differentiation control of skeletal muscle in different locations of the vertebrate body. Particular attention is paid to novel regulatory molecules and signals as well as to the heterogeneity of origin that have revealed a developmental overlap between skeletal and cardiac muscle. Different functional muscle groups are the product of the evolution of the vertebrate classes, making a phylogenetic comparison worthwhile for understanding the role of muscle stem cells and precursors in myogenesis. New insights into the hierarchy of transcription factors, particularly in the context of these different muscle groups come from detailed investigations of the spatio-temporal and regulatory relationships derived from mouse and zebrafish genetics and avian microsurgery. Importantly, epigenetic mechanisms that have surfaced recently, in particular the role of MyomiRs, are also surveyed. Regarding human patients, encouraging results have been generated that identify parallels between embryonic myogenesis and regenerating myofibers that share regulatory molecules. Interestingly, the heterogeneity in embryonic origins of skeletal muscle groups in the vertebrate including humans is paralleled by their different susceptibility to types of muscle dystrophies. The progress that has been made in the field of muscle stem cell biology, especially on satellite cells, is outlined in this book by experts in the field. The authors review recent insights of the heterogeneous nature of these satellite cells regarding their gene signatures and regeneration potential. An improved understanding of muscle stem cells seems only possible with a view to the cell environment, putting embryological and molecular findings from different vertebrate classes and stem cell approaches into context.

"This comprehensive review of vascular disease in the vertebrobasilar circulation is based on Dr Louis R. Caplan's extensive experience and observation of patients from the New England Medical Center posterior circulation stroke registry. It benefits from an organized, uniform, and coherent analysis of all types of vascular disease involving the posterior circulation, presented by a single author who is one of the world's leading authorities on this topic. This new edition is fully updated throughout, including a review of all the literature published on this topic since the previous edition in 1996. There are major rewrites for the chapters on diagnosis and therapy, inclusion of modern imaging techniques, and extensive illustrations. Essential reading for stroke physicians and neurologists, the book will also be an important source of reference for neurosurgeons, vascular surgeons and endovascular radiologists"--Provided by publisher.

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